Doctor Name: | DR. BENJAMIN K MARBLE |
NPI Number: | 1023172426 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 5943612-0501 |
Business Practice Address: | 1619 N Greenwood St # 300 Pueblo, CO - 810032657 |
Business Phone Number: | 7195432476 |
Business Fax Number: | 7195432479 |
Mailing Address: | 1619 N Greenwood St, #300 PUEBLO |
State: | CO |
Postal Code: | 810032657 |
Phone Number: | 7195432476 |
Fax Number: | 7195432479 |
NPI Enumeration Date: | 12/20/2006 |
NPI Last Update Date: | 04/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 5943612-0501 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |